Pregnancy Physical Activity Questionnaire Research Articles

The intention to undertake physical activity in pregnant women using the theory of planned behaviour.

To identify the intention of Chinese pregnant women to undertake physical activity (PA) using the theory of planned behaviour. A cross-sectional survey. From April - October 2017, a cross-sectional questionnaire was completed by 746 pregnant women from the Health Birth Cohort in Wuhan, China. The theory of planned behaviour variables as well as sociodemographic characteristics was recorded, and the Pregnancy PA Questionnaire was together used to assess their PA during pregnancy. Only 11.3% of the women met the international guideline. The intention to undertake PA was found it to be positive in 63.9% of pregnant women. Structural equation modelling analysis revealed that behavioural attitudes, subjective norms, and perceived behavioural control (PBC) influenced PA by directly influencing the behaviour intention. Both behavioural attitude and subjective norms influenced PA by indirectly affecting the behaviour. Overall, the model described 60% variance of the behavioural intention to undertake PA during pregnancy. PBC was confirmed to be a prominent factor in determining behavioural intention to undertake PA during pregnancy. Pregnant women should be helped and appropriately guided by health providers to overcome barriers to PA. This study investigates the effect of perceived behavioural control (PBC) on the intention to undertake physical activity (PA). The findings suggest that nurses' and midwives' attention should be focused on how to promote the improvement of perceived behavioural control ability of pregnant women to improve pregnant women's PA intention. The attitude of pregnant women on taking up PA and their ability to control behaviours can be improved with support from family or healthcare providers.

Pregnancy physical activity questionnaire (PPAQ): Translation and cross cultural adaption of an Arabic version.

Physical activity level during pregnancy is unknown in Middle Eastern and North African countries, since no valid tools assessing it exist in Arabic. The aim of this study is to culturally adapt and translate to Arabic an internationally validated instrument, the Pregnancy Physical Activity Questionnaire (PPAQ), and to measure the physical activity of pregnant women using the adapted PPAQ, Arabic version. This tool is time-sparing, self-administered and is the only one taking into account childcare and household chores. After following the guidelines for translation and back-translation by certified translators, a committee composed of professionals in the field reviewed each item of the PPAQ, for its comprehensibility. This Arabic version of the PPAQ was tested on a sample of 179 pregnant Lebanese women, from different educational backgrounds, socioeconomic status and gestational ages. Cross-cultural adaptations were applied on the newly translated PPAQ in Arabic version, thus questions referring to some types of outdoor activities were excluded from the final format. Our results reported that 51% and 1.7% of women engage respectively in light and high intensity physical activity, while 18% had a sedentary lifestyle. Occupational type of activities were significantly more performed by women having a higher education (p value 0.001), as opposed to those who attended only high school, who were physically more active in household activities (p value 0.038). Second trimester was a period where pregnant women were active for household, caregiving (p value 0.031), whereas women in their third trimester were physically more active in occupational activities (p value 0.001). Sport-oriented activities were performed by women reporting a good physical status (p value 0.03). Age and crowding index were significantly correlated with occupational, household and caregiving activities (p values 0.004, 0.008 respectively). No significant correlations were observed with pre-gestational body mass index and the physical activity levels. A valid tool will help researchers in Arab countries identify physical activity levels of pregnant women and consequently emit specific guidelines relative to the importance and the benefits of a daily active lifestyle throughout gestation.

Validity of self-reported and objectively measured sedentary behavior in pregnancy

BackgroundSedentary behavior (SED) is a potential risk factor for poor pregnancy outcomes. We evaluated the validity of several common and one new method to assess SED across three trimesters of pregnancy.MethodsThis cohort study of pregnant women measured objective and self-reported SED each trimester via thigh-worn activPAL3 micro (criterion), waist-worn Actigraph GT3X, and self-report from the Pregnancy Physical Activity Questionnaire (PPAQ) and the de novo Sedentary Behavior Two Domain Questionnaire (SB2D). SED (hours per day) and percent time in SED (SED%) from activPAL were compared to GT3X, SB2D, and PPAQ using Pearson’s r, ICC, Bland-Altman analysis, and comparison of criterion SED and SED% across tertiles of alternative methods.ResultsFifty-eight women (mean age 31.5 ± 4.8 years; pre-pregnancy BMI 25.1 ± 5.6 kg/m2; 76% white) provided three trimesters of valid activPAL data. Compared to activPAL, GT3X had agreement ranging from r = 0.54–0.66 and ICC = 0.52–0.65. Bland-Altman plots revealed small mean differences and unpatterned errors, but wide limits of agreement (greater than ±2 h and ± 15%). The SB2D and PPAQ had r < 0.5 and ICC < 0.3 vs. activPAL SED, with lower agreement during the 2nd and 3rd trimesters, and performed poorly in Bland-Altman analyses. SED% from the modified SB2D performed best of the self-reported instruments with modest mean differences, r ranging from 0.55 to 0.60, and ICCs from 0.31–0.33; though, limits of agreement were greater than ±35%. Significant trends in activPAL SED were observed across increasing tertiles of SB2D SED in the 1st and 3rd trimesters (both p ≤ 0.001), but not the 2nd trimester (p = 0.425); and for PPAQ SED in the 1st and 2nd trimesters (both p < 0.05), but not the 3rd trimester (p = 0.158). AcitvPAL SED and SED% increased significantly across tertiles of GT3X SED and SED% as well as SB2D SED% (all p-for-trend ≤ 0.001).ConclusionsCompared to activPAL, waist-worn GT3X produced moderate agreement, though similar mean estimates of SED across pregnancy. Self-report questionnaires had large absolute error and wide limits of agreement for SED hr./day; SB2D measurement of SED% was the best self-report method. These data suggest activPAL be used to measure SED when possible, followed by GT3X, and – when necessary – SB2D assessing SED% in pregnancy.Trial registrationwww.clinicaltrials.govNCT03084302 on 3/20/2017.

Factors Associated with the Leisure-Time Physical Activity (LTPA) during the First Trimester of the Pregnancy: The Cross-Sectional Study among Pregnant Women in Serbia.

Background: The benefits of physical activity during pregnancy include lower maternal weight gain, a lower likelihood of gestational diabetes, low back pain, preeclampsia, preterm delivery, caesarian delivery, and macrosomia. This study aimed to examine the factors associated with insufficient leisure-time physical activity (LTPA) during the first trimester. Methods: A cross-sectional study was conducted at the Clinic for Obstetrics and Gynecology of Clinical Center of Serbia, Belgrade, between January and June of 2018. The final analyses included 162/175 pregnant women. The questionnaire was used to obtain social characteristics, pregnancy, and lifestyle characteristics (Pregnancy Risk Assessment Monitoring System—PRAMS), pre-pregnancy LTPA (International Physical Activity Questionnaire—IPAQ), and LTPA during the first trimester (Pregnancy Physical Activity Questionnaire—PPAQ). Women were classified into two groups of sufficient and insufficient LTPA during the first trimester based on the recommendations of the World Health Organization. Multivariate logistic regression analysis was applied. Results: A total of 27.2% of the women had insufficient LTPA during pregnancy. Insufficient LTPA during pregnancy was associated with <12 years of education (OR: 2.3, 95% CI: 1.05–5.04), self-rated financial status as poor (OR: 0.34, 95% CI: 0.14–0.79), and hours spent walking before pregnancy (OR: 0.87, 95% CI: 0.77–0.99). Conclusions: Our results can help direct health care professionals advice for women who are planning pregnancy towards walking as it seems to be sustained during pregnancy.

Improving Health of the Next Generation: Dietary Intake and Physical Activity during Pregnancy in an Austrian Cohort

AbstractThere is sufficient evidence that the periconceptional period is a key window during which poor maternal nutrition can adversely influence long-term health and disease risk into adulthood. The higher rate of obesity in women of childbearing age and bad quality of mother's diet may result in higher incidence of hyperglycemia or hyperlipidemia, associated with an impaired metabolism in the offspring.This cross-sectional study analysed dietary habits and physical activity of 190 pregnant women aged 31 ± 6 years in the second and third trimester of their pregnancy in Austria. Dietary intake data were collected by two non-consecutive 24-h-recalls using GloboDiet software, physical activity was examined with the Pregnancy Physical Activity Questionnaire. 31.6 % of investigated women were overweight or obese; a moderate higher prevalence compared to non-pregnant women (21.9–27.8 %). Mean gestational weight gain (GWG) was 3.9 (± 4.8) kg in the second and 9.6 (± 5.1) kg in the third trimester. More than half of the pregnant women exceed the GWG recommendations of the Institute of Medicine (2009). In contrary, average energy consumption was 1765 kcal/d, which is below the DACH (German, Austrian and Swiss Society for Nutrition) reference value assuming a Physical Activity Level of 1,4. However, one quarter of participants exceeded reference value of energy intake. Ratio of energy supply by macronutrient intake was 36.2 E% fat: 48.5 E% carbohydrates: 15.3 E% protein. Mean intakes of linoleic acid and alpha-linoleic acid were within the DACH reference values, but DHA intake (125 mg/d) did not reach the recommendation of 200 mg/d. In addition, average intake of dietary fibre (19.8 g/d) was too low. Intakes of vitamins A, E, B1, B6, and folate as well as potassium, calcium, magnesium, iron, zinc, and iodine were unsatisfying. These results are in accordance with an inadequate supply with fruits, vegetables, cereals, and milk products, at the same time exceeding intake of meat(products) and sweets. Only half of the examined pregnant women have reached the recommendation of 120 minutes of physical activity of moderate to vigorous intensity per week.This study demonstrates that dietary behaviour and physical activity during pregnancy need to be improved. Adequate energy and nutrient intake is essential before conception, as well as throughout pregnancy to support maternal needs, and to fill up stores required for foetal development. Health strategies supporting women in childbearing age in adopting a healthy lifestyle are important for the health of the next generation.

CORRELATION BETWEEN PREGNANT PHYSICAL ACTIVITY WITH PREECLAMPSIA IN WORKING AREA OF TEMPUREJO PUBLIC HEALTH CENTER, JEMBER

Preeclampsia is one of pregnancy complication which is the biggest cause of maternal and infant mortality. The cause is not yet known but many risk factors can affect the occurrence of preeclampsia, one of which is physical activity. The purpose of this study was to analyze the correlation between the physical activity of pregnant women with the incidence of preeclampsia in the work area Tempurejo Public Health Center, Jember. The research design used in this study was analytical-survey with a cross-sectional approach. Respondents in this study were 77 pregnant women taken by total sampling. Data collection was conducted using PPAQ (Pregnancy Physical Activity Questionnaire) and maternal and child health book. Data analysis was performed using the chi-square test. This study found that 39 respondents (50,6%) showed good physical activity. The chi-square test showed no correlation between the physical activity of pregnant women and the incidence of preeclampsia in the work area of Tempurejo Community Health Center, Jember with the p-value 0.557 (P &gt; α = 0,05). There is no difference in physical activity between preeclampsia and non-preeclampsia women because all respondents are included in the mild preeclampsia group. In mild preeclampsia, subjective symptoms are not felt by pregnant women so that some pregnant women do not limit physical activity and pregnant women who work still do work activities such as normal pregnant women. Health workers are expected to provide nursing care related to the prevention of preeclampsia way through education and routine antenatal care.

Physical activity, sedentary behavior and development of preeclampsia in women with preexisting diabetes.

To explore the association between physical activity in early pregnancy and development of preeclampsia in women with preexisting diabetes. In a prospective cohort study of 189 women with preexisting diabetes (110 type 1 and 79 type 2 diabetes), physical activity during pregnancy including sedentary behavior was evaluated with the Pregnancy Physical Activity Questionnaire. Primary outcome was preeclampsia. Secondary outcomes were preterm delivery, large and small for gestational age infants. Women developing preeclampsia (n = 23) had higher diastolic blood pressure in early pregnancy (mean 82 ± 9 SD vs. 77 ± 8, p = 0.004) and were more often nulliparous (91 vs. 52%, p < 0.001) compared with the remaining women (n = 166). Total physical activity in early pregnancy was similar between the groups (median 148 metabolic equivalent of task hours per week (MET-h/week) (interquartile range 118-227) versus 153 (121-205), p = 0.97). In early pregnancy, women developing preeclampsia reported a higher level of sedentary behavior (15 MET-h/week (7-18) versus 7 (4-15); p = 0.04); however, when adjusting for parity, diastolic blood pressure and smoking, the association attenuated (p = 0.13). Total physical activity and sedentary behavior in early pregnancy were not associated with preterm delivery, large or small for gestational age infants. Among women with diabetes, sedentary behavior was reported higher in early pregnancy in women developing preeclampsia compared with the remaining women, while total physical activity was similar. Sedentary behavior was a predictor of preeclampsia in the univariate analysis, but not in the multiple regression analysis, and larger studies are needed to evaluate this possible modifiable risk factor. Trial registration The study was registered at ClinicalTrials.gov (ID: NCT02890836).

A feasibility study of activity tracking devices in pregnancy

BackgroundWe aimed to evaluate the feasibility of using an activity-tracking device (ATD) during pregnancy and compare self-reported to ATD-calculated energy expenditure in a 2-phase study.Methods(Phase 1) Twenty-five pregnant women were asked about exercise, computer use, smartphone ownership, and ATD attitudes. Descriptive statistics were reported. (Phase 2) Women ≥18 years, smartphone owners, < 16-weeks gestation, and without exercise restrictions were approached to participate in 2016–2017. Women received instructions to wear and sync the ATD daily. We assessed protocol adherence and satisfaction via surveys at 36-weeks and used mixed models to assess the relationship between gestational age and ATD data. Energy expenditure from the Pregnancy Physical Activity Questionnaire (PPAQ) was compared to ATD-calculated energy expenditure.Results(Phase 1) Walking was the most common exercise; 8% did not perform any activity during pregnancy. All women had internet access and owned a smartphone. Women stated they would wear the ATD all the time during a pregnancy (88%), with the intent to improve their health (80%). (Phase 2) The characteristics of the 48 women were: pre-pregnancy BMI 28, 62% non-Hispanic black, 62% multiparas. Of the 18 women who completed the 36-week survey, only 56% wore the ATD daily, 33% had a lost or broken ATD, and 17% had technical problems; however, 94% enjoyed wearing it, 94% would recommend it to a pregnant friend, and 78% thought it helped them reach activity goals. According to ATD data, the median number of active days was 41 (IQR 20–73) and the median proportion of active days out of potential days was 22% (IQR 11–40). As gestational age increased, mean log steps decreased, active minutes decreased, and sedentary hours increased in unadjusted and adjusted models (P < 0.05 all comparisons). There were no differences in mean energy expenditure (MET-h/week) estimated by PPAQ or ATD data at 28 weeks gestation [212 (22–992 range) vs. 234 (200–281 range), P = 0.66] and at 36 weeks [233 (86–907 range) vs. 218 (151–273 range), P = 0.68]).ConclusionsWomen reported high motivation to wear an ATD and high satisfaction with actually using an ATD during pregnancy; however adherence to the study protocol was lower than expected and ATD technical problems were frequent.

Associations between Prenatal Physical Activity and Neonatal and Obstetric Outcomes-A Secondary Analysis of the Cluster-Randomized GeliS Trial.

Prenatal physical activity (PA) was discussed to decrease the incidence of obstetric and neonatal complications. In this secondary cohort analysis of the cluster-randomized GeliS (“healthy living in pregnancy”) trial, associations between prenatal PA and such outcomes were investigated. PA behavior was assessed twice, before or during the 12th week (baseline, T0) and after the 29th week of gestation (T1), using the self-reported Pregnancy Physical Activity Questionnaire. Obstetric and neonatal data were collected in the routine care setting. Data were available for 87.2% (n = 1994/2286) of participants. Significant differences between the offspring of women who adhered to PA recommendations at T1 and offspring of inactive women were found in birth weight (p = 0.030) but not in other anthropometric parameters. Sedentary behavior was inversely associated with birth weight at T1 (p = 0.026) and, at both time points, with an increase in the odds of low birth weight (T0: p = 0.004, T1: p = 0.005). Light-intensity PA at T0 marginally increased the odds of caesarean section (p = 0.032), but neither moderate-intensity nor vigorous-intensity activity modified the risk for caesarean delivery at any time point. The present analyses demonstrated associations between prenatal PA and some neonatal and obstetric outcomes.

The Reliability and Validity of the Turkish Kaiser Physical Activity Survey for Pregnant Women.

Evaluation of physical activity by condition-specific surveys provides more accurate results than generic physical activity questionnaires. The aim of this study was to investigate the reliability and validity of the Kaiser Physical Activity Survey (KPAS) in Turkish pregnant women. In the translation and cultural adaptation of the KPAS, the 6-phase guidelines recommended in the literature were followed. The study included a total of 151 pregnant women who were assessed using the Turkish version of KPAS, the Pregnancy Physical Activity Questionnaire, and the SenseWear Pro3 Armband. To determine the test-retest reliability, the KPAS was reapplied after 7 days. The psychometric properties of KPAS were analyzed with respect to internal consistency, test-retest reliability, and concurrent validity. Cronbach α coefficient indicating the internal consistency of the Turkish KPAS was found to be .60 to .80, showing moderate reliability. The intraclass correlation coefficient for test-retest reliability was very strong (intraclass correlation coefficient: .96-.98). The total KPAS scores were found to be moderately correlated with the total Pregnancy Physical Activity Questionnaire score and the total energy expenditure value on the SenseWear Pro3 Armband. This study showed that KPAS is a valid and reliable instrument for evaluating physical activity in Turkish pregnant women in different aspects.

The effect of prenatal maternal physical activity and lifestyle in perinatal outcome: results from a Greek study.

Several maternal characteristics, including lifestyle, have been associated with perinatal outcomes and birth anthropometric characteristics of the offspring. This study aimed to identify whether physical activity (PA) and other lifestyle parameters of the mother are associated with the pregnancy outcomes or with the infant's birth anthropometric characteristics. Participants were recruited in Mitera Maternity Hospital, Athens, Greece. Socio-demographic, medical history and anthropometric assessment took place. PA during pregnancy was assessed with the Pregnancy Physical Activity Questionnaire. Dietary assessment was conducted with the Food Frequency Questionnaire and adherence to the Mediterranean diet was evaluated with the MedDiet score. Birth weight and gestational age data were also collected. Sedentary-intensity activity scores increased with increased educational level, while moderate-intensity activity scores decreased with increased educational level. Pregnant women who delivered large for gestational age infants had lower sports activity score. Higher vigorous and sports activity score was demonstrated in cases with a vaginal delivery compared with caesarean section. PA score was significantly and positively correlated with several nutrient intakes and PA was higher in women with a healthier nutritional pattern. Increased MedDiet scores were found in mothers with increased educational level. Overall, PA was higher in women with a healthier nutritional pattern. An increased vs. a low activity level during pregnancy is positively associated with vaginal delivery and with the size of the offspring.

Adequacy of Nutrients Intake among Jordanian Pregnant Women in Comparison to Dietary Reference Intakes.

Objective: Maternal nutrition is considered an important pillar in the pregnancy outcomes for both mother and infant. A mother’s malnutrition and inadequate nutrient intake is associated with many undesirable pregnancy outcomes. Hence, assessing the nutritional status of the mother in the early stages of the pregnancy and preventing any inadequacy can preclude many health problems for both mother and infant. Therefore, this study aimed to assess the adequacy of nutrient intakes among Jordanian pregnant women as compared to their corresponding dietary reference intakes (DRIs). Methods: This cross-sectional study was conducted at a major University Hospital in Jordan. Three hundred pregnant women were invited to participate in the study and 286 agreed to participate. Fifty pregnant women were enrolled at week 9, then 96 pregnant women were at week 20 and 137 pregnant women were at week 30 of pregnancy. The participants completed the interview-based demographic questionnaire, pregnancy physical activity questionnaire, and quantitative food frequency questionnaire (FFQ). Results: The mean energy intake was 2768.9 ± 767.8 kcal/day and it was significantly higher in the 3rd trimester (p < 0.05). Women in the 3rd trimester consumed significantly more protein, carbohydrates, and sugar than women in the 1st and 2nd trimesters (p < 0.05). The pregnant women in the 3rd trimester consumed more sodium than women in the 1st and 2nd trimesters (p < 0.05). The vitamin K intake was significantly (p = 0.045) lower in the 2nd trimester than the 1st and 3rd trimesters. The calcium intake was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p = 0.021). The total micronutrient (vitamins B1, B2, B3, B6, B12, and D, calcium, and iron) intakes derived from dietary supplements and food sources throughout the 3 trimesters was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p < 0.05). The vitamin D, calcium, and iron intakes had the most significant increases between the 1st and 3rd trimesters (p < 0.001), while folic acid intake was significantly higher in the 1st trimester than the 2nd and 3rd trimester (p < 0.001). Most women exceeded the tolerable upper intake level (UL) for sodium in all trimesters, while 82% of women exceeded the UL of folic acid in the 1st trimester and from the supplement, not the diet. Conclusion: While the intake of some nutrients from food alone remains below the DRIs in the diets of pregnant women, the intake of other nutrients is above the UL. Raising the awareness of pregnant women about their diet and how a supplement intake can reduce the risk of inadequate intake for many micronutrients and improve their pregnancy outcomes is of great importance.

Reliability and validity of Turkish version of pregnancy physical activity questionnaire (PPAQ) in patients with gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a common complication during pregnancy. Evaluation of the quantitative physical activity in diabetic pregnant women is critical. The aim of this study was to test the reliability and validity of the Pregnancy Physical Activity Questionnaire (PPAQ) in Turkish patients with GDM. A total of 120 pregnant women between the ages of 18 and 44 years with GDM were included. The reliability of the questionnaire was measured by internal consistency and analysis of 2-week test-retest reliability. Of the patients, 74 completed the test-retest procedure. Concurrent validity was examined by comparing the PPAQ with the Short Form of the International Physical Activity Questionnaire (IPAQ) in 36 patients. Test-retest intraclass correlation coefficient scores varied between 0.72 and 0.95. The Spearman rank correlation analysis showed that the PPAQ total activity values were statistically significantly correlated with the total values of IPAQ-Short Form (r = 0.410 and p = .030). In conclusion, the Turkish version of the PPAQ is a valid and reliable tool for the measurement of the physical activity level of pregnant women with GDM.Impact statementWhat is already known on this subject? The pregnancy physical activity questionnaire (PPAQ) developed in 2004 by Chasan-Taber et al.; is a simple and short questionnaire measuring the frequency, duration, and intensity of physical activity in pregnant women. To date, this questionnaire has been translated into many languages and has been used in a number of studies.What do the results of this study add? The aim of this study was to test the reliability and validity of the PPAQ in Turkish pregnant women with GDM. On the basis of our study results, we suggest that the Turkish version of the PPAQ is a valid and reliable tool for the measurement of the physical activity level of pregnant women with GDM.What are the implications of these findings for clinical practice and/or further research? Evaluation of the quantitative physical activity in diabetic pregnant women may contribute to gain a better understanding of the role of physical activity during treatment and may be useful to compare the results of different studies carried out in different places more effectively.

Physical activity patterns in third trimester of pregnancy - use of pregnancy physical activity questionnaire in Poland.

Adverse pregnancy outcomes are less common among physically active women, and children born to such mothers are less likely to be at risk for macrosomia, obesity and metabolic diseases in the future. The aims of the study were to establish physical activity (PA) patterns among pregnant women in the third trimester, and to determine the attitudes of prenatal care providers to maternal PA during pregnancy. The study was conducted in 2017 using surveys from the Polish Pregnancy-related Assessment Monitoring System program (Pol-PrAMS). The study included 3,451 postpartum women. The Pregnancy Physical Activity Questionnaire was used to investigate their PA. This part of Pol-PrAMS study was completed by 2,744 postpartum women who were subjected to statistical analysis. Sedentary or light physical activity comprised 75% of the overall PA in the third trimester of pregnancy (mean values of energy expenditure: 67 and 93.3 MET-h/week, respectively). Household or caregiving activities accounted for almost 50% of all activities and were the most common PA types (mean energy expenditure: 105 MET-h/week). Restriction of PA in pregnancy was reported by over 60% of the women, most often due to concerns over proper foetal development. Over 85% of prenatal care providers either did not address the issue of PA with the future mothers at all, or recommended PA restriction. Sedentary and light-intensity PA are the two predominant types of physical activity in the third trimester. The most energy-consuming tasks involve household and caregiving activities. Restriction of activity was reported by the majority of the respondents. Prenatal care providers either did not address the matter of PA in pregnancy or recommended PA restriction.

Do the body mass index and the diagnosis of gestational diabetes mellitus influence the level of physical activity during pregnancy and postpartum?

Obesity and lack of physical exercise are associated with the increase of diabetes mellitus in women of reproductive age and during the gestational period. The objective of the present study was to evaluate physical activity levels during the pregnancy and postpartum periods and the influence of body mass index (BMI) in women with gestational diabetes mellitus (GDM) or low risk pregnancy. The Pregnancy Physical Activity Questionnaire (PPAQ), translated and validated for Portuguese, was used for the evaluation of physical activity (PA) level. The sample was stratified according to preconception BMI and the presence or absence of diagnosis of GDM, resulting in four groups with 66 participants each: low risk pregnancy (LRP) with normal weight (BMI ≥ 18.5 and ≤ 24 kg/m2), LRP and overweight/obese (BMI ≥ 25 kg/m2), GDM with normal weight and GDM with overweight/obese. The level of PA of each participant was measured as Metabolic Equivalent of Task (MET) during the preconceptional period (T0), in the third trimester of gestation (T1), and three months after delivery (T2). The comparison of the MET values showed that the values found in the evaluation three months after delivery (T2) were higher than 1.00 (1.10 MET for the LRP-normal weight, 1.06 MET for LRP-overweight/obese, 1.02 MET for the GDM- normal weight, 1.07 MET for the GDM-overweight/obese). On the pre-gestational (T0) and third trimester (T1) analyzes, the values were less than 1.00 MET. The analysis between groups in relation to BMI and diagnosis of GDM showed no difference.

Assessment of physical activity status among pregnant women in southwestern China

Abstract Objective To assess the patterns and intensities of physical activity among pregnant women in southwestern China, which help us create a fitness regimen based on the 2002 American College of Obstetricians and Gynecologists (ACOG) guidelines for exercise during pregnancy. Methods A cross-sectional study was performed to recruit pregnant women at a prenatal checking visit clinic with the self-administered Chinese version of Pregnancy Physical Activity Questionnaire (PPAQ). Results A total of 1179 Chinese pregnant women were enrolled, of whom 92.60% were classified as not meeting the ACOG guidelines. By intensity, 47.36% of the score was attributed to light-intensity activities (1.5 to &lt;3.0 metabolic equivalent [MET]) in the first trimester; the other 2 trimesters were similar. By patterns, about 45.15% of the score was attributed to inactivity. More than 82.35% of enrolled pregnant women regarded slowly walking as the most common type of exercise during pregnancy. Conclusions This study represents a group of Chinese women who maintained an inactive lifestyle, including low-intensity activities and unitary type of exercises during their pregnancy. Health-care providers are advised to provide appropriate physical activity guidelines to pregnant women. Development of MET-hours/week recommendations is warranted to promote greater physical activity during pregnancy.

Physical Activity and Health-Related Quality of Life in Pregnant Women

Background:Physical activity (PA) and health-related quality of life (HRQoL) are significantly affected in pregnancy.Objectives:The aim of this study was to assess these constructs among Nigerian pregnant women and also examine the relationshipbetween them.Methods:A total of 140 pregnant women were recruited from four selected antenatal clinics in Ile-Ife, Osun State, Nigeria, whoparticipated in this cross-sectional study. The pregnancy physical activity questionnaire (PPAQ); consisting of 33 questions aimed atevaluating different day to day activities and SF-12 health survey; an eight scale grouped questionnaire were used to assess PA andHRQoL, respectively. Descriptive statistics (mean, standard deviation, frequency, and percentage) and inferential statistics (Pearsonproduct moment correlation and one-way ANOVA) were used for data analysis. Alpha level was set at P 0.05) across the three trimesters of pregnancy except for physical functioning (P = 0.023). However,there were significant differences in PA across the three trimester of pregnancy (P < 0.05), except for vigorous intensity (P = 0.072),sport (P = 0.057), and occupational activity (P = 0.057). There were significant correlations among HRQoL sub-scales and each ofhousehold, occupational, and moderate intensity PA only (P < 0.05).Conclusions:Light to moderate intensity and household PA are predominant among Nigerian pregnant women than vigorousintensity, occupational, and sports-related PA. Higher health perception and physical role limitation in HRQoL were mostly demon-strated by the pregnant women. There was a significant inverse relationship between HRQoL and each of moderate intensity, occu-pational, and household PA.

Physical activity and sleep quality and duration among Hispanic postpartum women at risk for type 2 diabetes: Estudio PARTO

ObjectivesPoor sleep among postpartum women is associated with adverse maternal outcomes. Physical activity (PA) is associated with better sleep. However, few studies have been conducted among postpartum Hispanic women. The objective of this study was to examine the association between PA and sleep quality and duration among postpartum Hispanic women. DesignA cross-sectional analysis using baseline data from Estudio PARTO, an ongoing randomized controlled trial aimed at reducing type 2 diabetes risk among Hispanic women. SettingBaystate Medical Center, in Western Massachusetts, which serves an ethnically and socioeconomically diverse population. ParticipantsHispanic women, at elevated risk for type 2 diabetes, at a mean of 11 weeks (SD = 4.5) postpartum. MeasurementsPA was measured with the Pregnancy Physical Activity Questionnaire (PPAQ), and sleep was measured with the Pittsburgh Sleep Quality Index (PSQI). ResultsMean sleep duration was 5.9 hour/night (SD = 1.7) and PSQI score was 6.5 (SD = 3.9). In multivariable logistic models, sports/exercise was associated with lower odds of very poor sleep quality (PSQI >10) (OR = 0.18, 95% CI = 0.05 to 0.69). Sports/exercise (OR = 0.05, 95% CI = 0.01 to 0.26) and vigorous intensity PA (OR = 0.13, 95% CI = 0.04 to 0.42) were associated with lower odds of short (vs normal) sleep duration. There were no statistically significant relationships between PA in any other domain or intensity and sleep quality or duration ConclusionsFindings can inform interventions designed to improve postpartum sleep via increasing opportunities for exercise among postpartum women.

356-OR: Effects of First Trimester Exercise on Pregnancy Hyperglycemia and GDM

Structured, exercise-only interventions reduce the odds of GDM, but motivated trial participants are likely unrepresentative. Studies of free living exercise in population-based cohorts are needed and causal inference methods, which emulate randomized trials under specific a priori assumptions, represent the best alternative for observational data. This study estimates the causal effects of first trimester exercise on the risks of abnormal screening after a 50-OGTT, GDM diagnosed by the Carpenter-Coustan criteria, and abnormal glucose according to the Carpenter-Coustan thresholds for the 100-g OGTT. Data come from PETALS, a prospectively followed pregnancy cohort (n= 2,070, 70% from minority racial-ethnic groups) receiving care at Kaiser Permanente Northern California in 2013-2017. A Pregnancy Physical Activity Questionnaire was completed at 12.8 weeks gestation, on average (SD 2.5). Targeted Maximum Likelihood with data-adaptive estimation (a.k.a., machine learning) of propensity scores and outcome regression with recognized confounders (e.g., prepregnancy BMI, diet, education) was used to obtain causal risk differences for all women having exercised versus not. Exercise was defined as performing any amount of vigorous intensity exercise or meeting the cohort’s 75th percentile for moderate to vigorous intensity exercise (MVPA; ≥ 13.3 MET hours per week). The prevalence of abnormal screening was 23.8% and GDM 6.2%. Any participation in vigorous exercise significantly decreased the risk of GDM by 1.6 fewer cases per 100 women, and abnormal 1-hour and 2-hour OGTT values by 2.7 and 1.8 fewer cases, respectively, per 100 women. Meeting the 75th percentile for MVPA significantly decreased the risks of abnormal screening and abnormal 2-hour OGTT values by 5.2 and 2.5 fewer cases per 100 women, respectively. Findings suggest that, during the first trimester, any amount of vigorous intensity exercise or a high volume of moderate to vigorous intensity exercise reduces hyperglycemia later in pregnancy. Disclosure S.F. Ehrlich: None. R. Neugebauer: None. J. Feng: None. M.M. Hedderson: None. A. Ferrara: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (K01DK105106, P30DK092924); National Institute of Environmental Health Sciences (R01ES019196)

Do Pregnant Women Change Their Diet and Physical Activity After Gestational Diabetes Diagnosis? Findings from a Longitudinal Multi-racial U.S. Prospective Cohort (P16-016-19)

ObjectivesWomen diagnosed with gestational diabetes (GDM) are usually advised to reduce carbohydrate intake and increase physical activity (PA). There is limited longitudinal population-based evidence on whether these women change their diet and PA after diagnosis. Our aim was to examine if women with GDM do in fact alter their diet and PA post diagnosis and identify characteristics of women with favorable changes. MethodsThis study included 1735 women from the NICHD Fetal Growth Studies-Singletons (2009–2013) who completed an Automated Self-Administered 24-Hour dietary recall and a Pregnancy PA Questionnaire at 16–22, 24–29, 30–33, 34–37, and 38–41 (PA only) gestational weeks (GW). GDM was ascertained by medical records (n = 85; 4.9%), diagnosed at a mean of 27.7 GW (S.D. 4.7). We used adjusted linear mixed models with random effects to estimate changes in diet/PA post-GDM screening (non-GDM)/diagnosis (GDM) and tested for differences by GDM status. For factors that changed among women with GDM, we tested for differences by covariates. ResultsWomen with GDM significantly reduced total sugar intake after diagnosis by 27.9 g/d (95% confidence interval −41.5, −14.3), while it increased in women without GDM by 3.7 g/d (0.7, 6.7) after screening (Figure). Specifically, women with GDM reduced added sugars [−12.0 g/d (−22.0, −2.0)] and fruit juice [−0.4 serving/d (−0.6, −0.2)], and increased artificially sweetened beverage intake [0.2 servings/d (0.1, 0.3)]. The significant reduction in total sugar persisted in all women except Hispanics [−9.0 g/d (−27.2, 9.3); P-interaction = 0.08] and non-nulliparous women [−10.7 g/d (−25.5, 4.2); P-interaction = 0.001]. Women with GDM performed less moderate intensity PA [−30.6 MET-hr/wk (−43.2, −18.0)] after diagnosis than before, which was less than women without GDM [−17.1 (−19.9, −14.3)]. ConclusionsMajority of women with GDM undergoing usual care substantially decreased their overall sugar intake after diagnosis primarily by reducing added sugars and fruit juice, and increasing artificially sweetened beverages. Greater dietary counseling efforts may be needed among Hispanic and multiparous women, and for PA in all women with GDM. Funding SourcesThis research was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Supporting Tables, Images and/or Graphs▪